The nuclear grading system of Fuhrman et al correlates with prognosis in patients with renal cell carcinoma.
Technique:
(1) Grading performed on least differentiated areas, even if only focal.
(2) Multiple grades coexist in about 15% of tumors.
Grade
Nuclear Diameter in microns
Nuclear Outline
Nucleoli
Additional Features
I
10
round, regular and uniform
absent or inconspicuous
II
15
irregular
can be seen at high power (400x), but not on low power (100x)
III
20
prominent, easily seen at low power
IV
very irregular
bizarre shapes
multi-lobed
heavy chromatin clumps
The sarcomatoid pattern has a poor prognosis and are Grade IV.
Probability of Distant Metastasis After Nephrectomy (France)
5 Year Acturarial Survival (France)
2%
76%
9%
72%
17%
51%
30%
35%
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Purpose: To use the grading system of Fuhrman et al to predict prognosis for a patient with renal cell carcinoma.
Specialty: Hematology Oncology, Surgery, general, Nephrology
Objective: severity, prognosis, stage
ICD-10: C64,
